Expression And Clinical Correlation Study Of CAS In Acute Leukemia

Objective:To explore the expression of cellular apoptosis susceptibility(CAS)in bone marrow of patients with acute leukemia,and analyze its correlation with clinical characteristics,such as sex,age,white blood cell,platelet,bone marrow blast cell ratio,ki-67 index,risk stratification of cytogenetic and molecular biological prognosis,extramedullary infiltration and so on.Methods:A total of 91 patients with acute leukemia diagnosed for the first time in the Second Hospital of Shanxi Medical University from June 2018 to September 2019 were chosen to be the case group,including 54 acute myeloid leukemia(AML)cases and 37 cases of acute lymphoblastic leukemia(ALL);in the same period,selected 24 non-hematological malignant diseases patients as the control group.The expression of CAS in bone marrow biopsies of patients with acute leukemia and non-hematological malignant diseases was detected by immunohistochemical method.Compare the expression of CAS between the case group and the control group,and discuss the correlation between the expression of CAS and clinical features in AML and ALL.Results:(1)Expression of CAS in bone marrow biopsies of patients with acute leukemia and non-hematological malignant diseases.CAS was mainly located in the cytoplasm in both groups.Among the 54 cases of AML,14 cases(25.9%)had high expression of CAS.Among the 37 cases of ALL,10cases(27%)had high expression of CAS.The expression of CAS was low in all 24 patients in the control group.The high expression rate of CAS in AML and ALL was respectively significantly more than the rate in the normal controls(P<0.0167).The high expression rate of CAS between AML and ALL groups was different minglessly.(2)The correlation between the expression of CAS and the clinical characteristics of patients with AML.The expression of CAS in AML was not significantly correlated with age,sex,white blood cell,platelet,bone marrow blast cell ratio,extramedullary infiltration and so on.There were differences in the risk stratification of cytogenetic and molecular biological prognosis and the remission rate of the first chemotherapy between the CAS high expression group and the CAS low expression group,and the difference was remarkably significant(P<0.05).The perception of high risk patients and patients without remission after the first chemotherapy in the highly expressed CAS group was different from the less expressed CAS group,and former was significantly superior to the latter.The perception of low-risk patients and patients with complete remission after the first chemotherapy was remarkably inferior to that in the CAS low expression group.The ki-67 index in bone marrow tissue of CAS high expression patients was superior to that of CAS low expression patients,and the difference was statistically meaningfully(P<0.05).(3)The correlation between the expression of CAS and the clinical features of ALL patients.In ALL,the expression of CAS was not significantly related with age,sex,WBC,platelet,bone marrow blast cell ratio,extramedullary infiltration,ki-67 index and remission rate of the first chemotherapy.There was significant difference in the risk stratification of cytogenetic and molecular biological prognosis between the high and low expression of CAS groups.In the prognostic risk stratification of highly expressed CAS group,the perception of high risk patients was superior to that of CAS low expression group,and the perception of low risk patients was inferior to that of CAS low expression group.Conclusion:CAS is located in cytoplasm in bone marrow biopsies of patients with acute leukemia and non-hematological malignant diseases.And its expression is increased in acute leukemia,which is related to the risk stratification of cytogenetic and molecular biological prognosis,the remission rate of the first chemotherapy,ki-67 index in patients with AML,and to the risk stratification of cytogenetic and molecular biological prognosis in patients with ALL,suggesting that CAS may participate in the occurrence and development of acute leukemia by promoting cell proliferation and is expected to become an important molecular marker to assess one’s condition and evaluate the prognosis.